Patients’ Views on the Differences between Three Types of Methadone Syrups in Iran: A Qualitative Study

Objective: This study was designed to compare the methadone syrups produced by three different pharmaceutical companies from the perspectives of patients and other concerned individuals. Materials and Methods : A qualitative study was conducted via content analysis. Through purposive sampling 26 substance abuse patients were selected and interviewed through focus group discussions. Other concerned individuals included: clinic nurses (3 persons), drug experts in the ‘Substance Abuse Office’ of medical universities’ ‘Food and Drug Administrations’ (2 persons), opiate drugs stock-keeper (1 person), clinic physician-technicians (2 persons), and, methadone retailers and brokers (2 persons). The latter underwent in-depth semi-structured interviews. Upon analysis the data were classified, coded and thematically grouped. Results : The extracted codes were classified into four main themes: 1.                  Physical characteristics : syrup color, odor, taste and consistency. 2.                  Therapeutic effects : onset of effect, potency and duration of effect. 3.                  Side-effects : generalized, sleep, gastrointestinal, cardiac, respiratory, dermatologic, sexual, nervous, muscular and psychological problems. 4.                  Opinions, feelings, thoughts and emotions following syrup change : apprehension of unfamiliarity, upset about change without prior notice, unpleasant feeling about constant changes, feeling disrespected, feeling deceived, feeling of being imposed. Conclusions : In a nutshell, patients’ dissatisfaction of the physical characteristics and mode of changing syrups was very prominent. The latter was also thought to have less potency and maintenance one of them as opposed to another. In addition to the low consensus on the drug’s side-effects, it is basically very difficult to attribute such effects to a specific pharmaceutical product when different products are used interchangeably.